Hello doctor,
My brother, who is 36 years old, has a lot of pain in the ball of his right foot. It is like a sharp pain both on the foot as well as in the toes. He is overweight with 98 kg and he is of height 5 feet 7 inches. He is taking NAC 75 painkillers. But, the pain comes back once he stops eating the painkiller. What can be done for this pain? What could be the cause? Also, his uric acid is high at 10 or 11. Please suggest some measures.
Hello,
Welcome to icliniq.com.
Gout is a condition with elevated uric acid levels. It commonly affects great toerather than ball of foot. Is your brother's great toe swollen along with the pain in the ball of the toe? How long he has been suffering from the pain? Since when he is aware of his uric acid status? Is he on any medication to control uric acid? What is his profession? Does he play contact sports? Do you have an X-ray of the affected foot? Kindly follow up with answers to these questions along with the image of the affected foot for evaluation.
Thank you.
Hi doctor,
I think his uric acid is high for three to four years. He has no swelling, but there is pain between the toes on both sides on top as well as the bottom. It is a sharp pain and on standing it becomes more. It happens six months back also. There was no injury or sports activity. It just started on its own. Can it be due to uric acid or any problem with the nerve?
Hi,
Welcome back to icliniq.com.
Yes, it is because of uric acid and not due to any nerve compression. This is a typical history of acute attacks of gout. He has to continue anti-inflammatory medication along with ice pack application intermittently to the affected area. It takes two to three weeks for the acute phase to settle and after which the uric acid-lowering drugs can be started.
Thank you.
Thank you doctor,
To get immediate pain relief, what medicine can he take?
Hello,
Welcome back to icliniq.com.
Your brother can continue the analgesics such as Ibuprofen 400 mg twice a day along with Omeprazole 20 mg once a day to provide relief from pain. There is no medication which can provide immediate relief. It will take time of two to three weeks for the inflammation to settle and only then uric acid lowering drugs can be started. If they are started before inflammation has settled, then it causes more pain in other joints too. So, avoid them at present. Application of ice is also very effective in decreasing pain and inflammation. Consult your specialist doctor, discuss with him or her and start the treatment with consent. Avoid taking high protein diets this protein products breakdown in the body and increase uric acid content. Also avoid the following food items. Red meat and organ meats, shellfish such as shrimp and lobster, refined carbohydrates (white bread, white rice, pasta and sugar), processed foods (chips, snack foods, frozen dinners), sugary beverages and alcohol. You can include the following foods to your diet: Skim milk, low-fat dairy products such as yogurt, cheese, cottage cheese, whole-grain products, plant oils (olive or canola or sunflower), vegetables, cherries and vitamin C supplements. These dietary modifications are for long-term relief rather than immediate results.
Thank you.
Hi doctor,
Should he stop eating chicken? He eats chicken a lot. What vegetables should he avoid? And what about eggs? Please explain.
Hello,
Welcome back to icliniq.com.
Chicken and meat can elevate uric acid levels and thus should be best avoided as much as possible. You can take them on an occasional basis. Meat has to be avoided totally if there are frequent acute attacks and uric acid levels are not easily controlled with medication. Even though certain vegetables are rich in purines, a component of protein, they do not elevate uric acid levels and a diet rich in vegetables and fruits should be taken. Egg is definitely a good source of protein as a replacement for meat. You can take up to six eggs in a week, preferably boiled.
Thank you.
Hi doctor,
Can he take Mobizox? Is it safe to have? How many are allowed for a day?
Hello,
Welcome back to icliniq.com.
Mobizox is a combination of three drugs Paracetamol, Diclofenac sodium and Chlorzoxazone. It is not indicated for your brother's condition. He can take any one of the following drugs with his doctor consent, one tablet up to twice a day after a meal:
Although Mobizox will reduce pain and is safe to take because of two drugs present in the combination, but it is not indicated for gout. The above mentioned dosage is in the view that you had mild, transient liver dysfunction and if there is any renal or hepatic (liver) abnormality, the dosage of these drugs may vary depending upon the renal or hepatic parameters.
Thank you.
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